701 BEACH AVE 101 REMODEL "SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-5814
INSPECTION PHONE LINE 247
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-1056
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL
Estimated Value: $40,000.00
Issue Date: 5/6/2015
Expiration Date: 11/2/2015
PROPERTY ADDRESS:
Address: 701 BEACH AVE 101
RE Number: 170237-0702
PROPERTY OWNER:
Name: FORBES, RAYMOND E & BARBARA H,
Address: 4975 E LAURE GREEN WAY
GENERAL CONTRACTOR INFORMATION:
Name: PAUL ASHLEY
Address:
Phone: 904-545-5416
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $125.00
BUILDING PERMIT FEE $250.00
STATE DCA SURCHARGE $3.75
STATE DBPR SURCHARGE $3.75
Total Payments: $382-50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OTTOWT
FILE COPY 800 Seminole Road, Atlantic Beach, FL 3223 M to
Office (904) 247-5826 Fax (904) 247-5845 �,X 5
;EFT�
Job Address: 7el ge_A4A AY6, V-vd Perrnitlwu�M���_,05(0
Legal Description /,"" 44&�eAV OFA&W Parcel # 170232-0740
Floor Area of Sq Yt 12
Valuation of Work$ 41t�,0.00 Proposed Work -be At'�d/cooled /76/ non-heated/cooled
I
Class of Work(circle one): New Addition <� Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(�) (�ircle one): Commercial
If an existing structure,is a fire sprinmer system installed? (Circle one)-4Z ZYei'� N/A
Florida Product Approval#
For multiple proaucts use product approval form
Describe in detail the type of work to be performed: 164_14,r_60,11 Ale e_ /r;k4l eva....41M-5
Cq 4 i.194_,r11,ir '-V
f P6.0—
Property Owner Information:
Name: A/ �2&v/jsov- Address: 3t/, )C%74q�erf "',-44 lq6�1
CitY_,,o0,b-,L1744 State E/Zip 3202?,g Phone 3,0'5- j?Bj-Z637
E-Mail or Fax# (Optional zq a 11T!;A-,,' 0 er,-ra; I ,
Contractor Information: CONTRACTOR EMAIEL ADDRESS: A6W!LV corll��UC+10,,
Company ame: in &ent: i:b_kA, 1 Askiew Lo
Address: 10 9 Ci i��
�9 s+ n —State FLZ zip,.3;?,�-5c>
Office PI X1_S74!5-15 4 j(t) Job Site/Contact Number Fax
State Certification/Registration# C, 6C i 2S 9 Q,-35
Architect Name&Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the
issuance of a permit and that all work will be pe�formed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void if work i's not commenced within six(6)months, or if construction or work is suspended or abandonedfor aWeriod of six(6)months at any time after
work is commenced I understand that separate permits must be securedfor Electricar Work, Plunibing,Sikns, ells,Pools, Furnaces, Boilers, Heaters,
Tanks andAir Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOVIi NOTICE OF
COMMENCEMENT.
I here,�b certify that I have read andexamined thi's application and know the same to be true and correct. All provisions of laws and ordinances governing this
type work will be complied w w specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
r "ff
provision,,of any otherfede a al law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name
....................................................................................................................................... .....pa 4.j. A. /I le.
Befo
_L Before me
,6e
this Day of . 20 / 5 this-10 Day of ESSIE MERIM I'S
My Comm.Expk:"Fs*b 102.2017
USAN MERCHA —Cornmission
Notary Public N-otary Public 0 WXY Assa
Commission#FF 020944
Bonded Thfough IfthooN Wxy Assn.
Expires August 3,2017
Bonded Thru Twy Fain In3unme Ma5-7019
177 1 177n.M
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building DepartDent.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us /.0)--/Z6_57
City web-site: http,://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:70/ j4A,&� Department review required Yes No
ilding
rMa'nning &Zoning
Applicant: AAhv
Tree Administrator
Project: Public Works
Public Utilities
0-,f A6 lei bu-Jdf, Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: OApproved. E]Denied.
(Circle one.) Comments:
(EE;p
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: [—]Approved as revised. DRnied-
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
state of N(.)TICF, OF COMMENCEMENT
County of 0'v 46�
To Whom It May Concern: -------------- Tax Folio No. 1 2
0,�33�7 -
The undersigned hereby inforins 1�p4t4lv>-
the Florida Statutes, the followill You that ii-lProvements will be made to certain real Property, and in accordance with Section 713 of
Legal Description 9 information is stated in tWs NOTICE OF COIWMENCE�IEN
Of Property being i'll-Proved: - ;?
Address of property being -j
improved: 4
General description of improvements: '2 YZ
s
r:
Jr q y-
Owne 01-L
Owner's interest ill site of the mprovement� Address: 7�6
Fee Simple Titleholder(if other than ownerj\:
rJf Name: —-------
C ntractor:
A;_Ll
Address: >
Telephone No.:
SuretY(if any) Fax No:
Address: -------- -��O�untOf B�ond$
Telephon
e
Fax No:
Name and address of anypersorl making a loan for the construction 0
Name: f the improvements
Address:
Phone No:
Name of Fax No:
Person within the State of Floric',;�� :;ther than himself
served: Name: designated by,,—.-
ownei upon whom notices or Other documents may be
Address-
Telephone No: Fax No: —
In addition to himself, Owner designates the following person to —
713.06(2)(b),Florida Statues. (Fill in at owner,s option) rec
eive a copy of the L'
Name: lenor s Notice as Provided in Section
Address:
Telephone NO:
Expiration date of Notice Of Commencement Fax No:
Specified): (the expiration date is one (1) Year from the date of recording unjess
a different date is
THIS SPACE FOR RECOR])ER,S USE ONLY o
*- ' -
Si ne .
Before i e li
Date:
ay of
or* C?
Of Fl d in the
04 Coun o
has personally appeared 12h, I I -- va], tatc
'Olt
Personally Known-
Doc#2,011511031118,OR BK117156 Paqelli93, Produced Identificati
Number Pages:I Notary Public: (-) r 1—0, 1,-:5 --------- or
Recorded 05i06/2101 5 at 10:14 AM, L�- k-�a�n
Ronnie Fussell CLERK CIRCUIT COURT DUVAL My colin-nission expires. VYI C ( cj�)-C�
OUNTY ER HAN
C T
#FF 020944
st
Bonded Thru Troy Fai.1---
-7
C
3Atil IWER HANT
RECORDING$10.0o
Commission#F 0209
rc Expires August 3 2017